BackgroundAmong older people in developed countries, social isolation leading to solitary death has become a public health issue of vital importance. Such isolation could be prevented by monitoring at-risk individuals at the neighborhood level and by implementing supportive networks at the community level. However, a means of measuring community confidence in these measures has not been established. This study is aimed at developing the Community’s Self-Efficacy Scale (CSES; Mimamori scale in Japanese) for community members preventing social isolation among older people.MethodsThe CSES is a self-administered questionnaire developed on the basis of Bandura’s self-efficacy theory. The survey was given to a general population (GEN) sample (n = 6,000) and community volunteer (CVOL) sample (n = 1,297). Construct validity was determined using confirmatory factor analysis. Internal consistency was calculated using Cronbach’s alpha. The Generative Concern Scale (GCS-R) and Brief Sense of Community Scale (BSCS) were also administered to assess criterion-related validity of the CSES.ResultsIn total, 3,484 and 859 valid responses were received in the GEN and CVOL groups, respectively. The confirmatory factor analysis identified eight items from two domains—community network and neighborhood watch—with goodness of fit index = 0.984, adjusted goodness of fit index = 0.970, comparative fit index = 0.988, and root mean square error of approximation = 0.047. Cronbach’s alpha for the entire CSES was 0.87 and for the subscales was 0.80 and higher. The score of the entire CSES was positively correlated with the GCS-R in both the GEN (r = 0.80, p < 0.001) and CVOL (r = 0.86, p < 0.001) samples.ConclusionsThe CSES demonstrated adequate reliability and validity for assessing a community’s self-efficacy to aid in its preventing social isolation among older people. The scale is potentially useful for promoting health policies, practices, and interventions within communities. This may help prevent social isolation among older people and contribute to overall well-being in aging societies in Japan and abroad.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3857-4) contains supplementary material, which is available to authorized users.

BackgroundElderly social isolation could be prevented by facilitating communication or mutual helping at the neighborhood level. The helping of elderly neighbors by local volunteers may relate to their community commitment (CC), but ways to measure CC have not been identified. The aim of the present study was to develop a Community Commitment Scale (CCS) to measure psychological sense of belonging and socializing in the community among local volunteers, for research in prevention of elderly social isolation. We also tested the CCS in a general population of the elderly.MethodsA pilot test of 266 Japanese urban residents was conducted to examine face validity for 24 identified items, of which 12 items were selected for the CCS, based on a 4-point Likert-type scale. The CCS was developed via self-report questionnaires to 859 local volunteers in two suburban cities and to 3484 randomly sampled general residents aged 55 years or older living in one of the cities. To assess concurrent validity, data were collected using the Brief Sense of Community Scale (Peterson; 2008) and two types of single questions on self-efficacy for helping elderly neighbors.ResultsItem analysis and factor analysis identified 8 items, which were classified between two datasets under the domains of “belonging” and “socializing” in the local volunteers and the general residents. Cronbach’s alpha (which conveyed the internal consistency of the CCS) was 0.75 in local volunteers and 0.78 in general residents. The correlation coefficients between the scores of the CCS and BSCS were 0.54 for local volunteers and 0.62 for general residents. ANOVA comparing the CCS between the confidence levels of the two types of single question of self-efficacy on helping elderly neighbors showed a strong relationship in the volunteers and residents.ConclusionsThese results demonstrate acceptable internal consistency and concurrent validity for the CCS, with the two dimensions “belonging” and “socializing”, among the local volunteers and general residents in urban Japanese areas. Community commitment measured by the CCS was related to the degree of confidence for self-efficacy in helping elderly neighbors to prevent elderly social isolation.

Background Community health workers in Japan are commissioned to work on a voluntary basis on behalf of their communities, to promote healthy behaviors. They are a valuable resource because they can often provide health information and services for local residents with whom professionals find it difficult to engage. However, no instruments exist for evaluating perceptual and behavioral competencies for prevention of non-communicable diseases among voluntary unpaid community health workers in developed countries. This study aimed to develop a community health workers perceptual and behavioral competency scale for preventing non-communicable diseases (COCS-N), and to assess its reliability and validity. Methods We conducted a cross-sectional study using a self-reported questionnaire. A total of 6480 community health workers across 94 local governments in Japan were eligible to participate. We evaluated the construct validity of the COCS-N using confirmatory factor analysis, and assessed internal consistency using Cronbach’s alpha. We used the European Health Literacy Survey Questionnaire and the Community Commitment Scale to assess the criterion-related validity of the COCS-N. Results In total, we received 3140 valid responses. The confirmatory factor analysis identified eight items from two domains, with perceptions covered by “Sharing the pleasure of living a healthy life” and behavioral aspects by “Creating healthy resources” (goodness-of-fit index = 0.991, adjusted goodness-of-fit index = 0.983, comparative fit index = 0.993, root mean square error of approximation = 0.036). Cronbach’s alpha was 0.88. COCS-N scores were correlated with European Health Literacy Survey Questionnaire scores and Community Commitment Scale scores (r = 0.577, P < 0.001 and r = 0.447, P < 0.001). Conclusions The COCS-N is a brief, easy-to-administer instrument that is reliable and valid for community health workers. This study will therefore enable the assessment and identification of community health workers whose perceptual and behavioral competency could be improved through training and activities. Longitudinal research is needed to verify the predictive value of the COCS-N, and to apply it to a broader range of participants in a wider range of settings.

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Objective This study aims to describe the relationship between body mass index (BMI) and blood pressure in three distinct Peruvian populations. Methods Three population groups were recruited: Rural (born and remained in Ayacucho), Migrant (born in Ayacucho and migrated to Lima), and Urban (born in Lima). Systolic blood pressure (SBP) and diastolic blood pressure were measured using oscillometric devices (Omron M5-i, Japan) and standardised techniques. BMI was calculated from standardised measurements. ANOVA was used to test differences between groups. Multi-variable linear regression was used to describe the relationship between BMI and blood pressure, adjusting for potential confounders. Results SBP was similar in the rural (120.9618.7) and migrant groups (119.9616.4), but higher in the urban group (128.2622.9). BMI was significantly lower in the rural group (23.262.7), but similar in the migrant (27.064.3) and urban groups (28.365.4). There was a positive relationship between BMI and SBP (slope 0.81; 95% CI 0.59 to 1.03) after adjustment for age, sex, height and haemoglobin. A positive relationship was observed in urban residents (0.61; 0.04e1.18), but the gradient of the relationship was steeper in the migrant group (0.75, 0.48e1.02). Similar results were found for diastolic blood pressure. Conclusions The relationship between BMI and blood pressure differed between our three study populations, with blood pressure rising at lower values of BMI in migrants. Migrant population in transitional countries may be at greater risk of developing hypertension, and the effect of BMI as a predictor is not uniform in migrant and urban-born residents. Background Prevalence of cardiovascular disease and the risk factors associated with it are increasing globally and in particular throughout the developing world. The south Asian region is especially at risk because of the increasing prevalence of the said risk factors. The study was undertaken to investigate the impact of social class and area of residence in distribution of cardiovascular risk factors mainly hypertension and diabetes mellitus in Pakistan. Methods A cross-sectional study on 2495 subjects aged between 30 and 75 years was conducted in the Punjab province covering both the urban and rural areas. A detailed questionnaire was completed; anthropometric measurements and blood samples from the chosen subjects were taken after a written informed consent was obtained. Participants were categorised into urban and rural, and assigned a social class by occupation. A logistic regression model was used to explore the association between social class and the area of residence Results Overall prevalence of hypertension and diabetes was 24.21% and 16.63% respectively. Out of the total number of participants, 56.79% (n¼1417) were rural area residents while 43.21% (n¼1078) were urban. Urban individuals appeared significantly more likely (p<0.001) to be hypertensive (OR¼3.03, 95% CI 2.41 to 4.82) and more likely (p<0.001) to be diabetic (OR¼1.77, 95% CI 1.37 to 2.29) than rural ...